Abstract
BackgroundOverdose deaths have increased dramatically in the United States and are often attributed to prescription opioids. This study presents a framework for “overdose typologies”, including non-medical prescription drug use, to more accurately describe drug use patterns. MethodsThis study examined linked prescription drug monitoring program (PDMP) and toxicology data (2016–2018) from accidental overdose deaths from a large metropolitan coroner’s office in the Midwest (Indianapolis, Indiana). ResultsIn total, 1,112 accidental overdose deaths occurred and over two-thirds (68.0%; n = 756) were coded as an illicit drug user with no prescription opioid present in the toxicology. The most infrequent categories were prescription opioid users 5.5% (n = 61). ConclusionLinked PDMP and toxicology reports are useful in identifying drug use patterns that contribute to mortality.
Highlights
The United States is in the midst of an overdose crisis with more than a half million accidental drug overdose deaths having occurred since 2000, and over 70,000 deaths in 2017 alone (Scholl, 2019)
In the present study we further extend on the utility of prescription drug monitoring program (PDMP) access among coroners by linking three years (2016–2018) of PDMP and toxicology data from accidental overdose deaths from a large metropolitan coroner’s office
When there was no match with the above substances in the PDMP data, but these substances were found in the toxicology report, the case was coded as a nonmedical prescription opioid drug-related death
Summary
The United States is in the midst of an overdose crisis with more than a half million accidental drug overdose deaths having occurred since 2000, and over 70,000 deaths in 2017 alone (Scholl, 2019). The Prescription Drug and Abuse Policy System (PDAPS) reports that 31 jurisdictions have provided access to PDMPs for medical examiners and coroners for the purposes of investigating cause of death (Science, 2016). Under this configuration, PDMP records can be obtained by the coroner to determine which substances were prescribed. Federal and state efforts have focused on improving and integrating overdose data to provide more timely surveillance on a rapidly ever-changing public health crisis (Centers for Disease Control & Prevention, 2019); creating typologies can help to determine drug use prevalence patterns and how public health resources can be allocated to reduce overdose deaths. We can better assess the role of nonmedical opioid and non-opioid prescription drug misuse in fatal overdose deaths
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